Hangover

America will likely wake up Christmas morning with a terrible hangover.
The Senate seems hell-bent-for-leather to get some sort of health reform bill passed. Or maybe that is slip one past. The vote set for Christmas eve will give Americans no health, no reform, no care, and a huge bill.
Nominally the bill is to reduce cost by reforming the health care industry and the way that insurance against illness is paid. But because of concessions to special interest groups, the tax payers will end up footing the bill for universal insurance for the indigent while the “Cadillac” health plan covered folk escape paying the proposed fees due to carve-outs and special exceptions.
Medicare pays so little for many procedures that many caregivers will not accept new patients if their only insurance is Medicare. If all patients fees are regulated at the same rate, the level of care will decline, if only because doctors and other personnel leave the system to find something they can afford to do. No there will not be death committees, but you may have to wait so long for care that you do die or wish you could.
This is not reform. This is more of the same nonsense that caused the problem in first place.
My recommendation:
End the deductibility of payroll health insurance. This should be taxable income to the recipient. This gets non-health care business out of the health care business.
End the limits that states can put on health plans sold in state. This would open the markets to all comers and give consumers price and coverage choices that are not available today. Existing consumer protection laws could be used to prevent fraud and abuse.
Have individuals pay for all medicine and procedures. Have insurance companies reimburse the individuals if they are insured. This will ensure that, where possible, families will shop for value, achieving a balance between level of care and affordability.
Publish the secret codes that describe medical procedures. This would allow consumers to ensure that they are billed for the care actually administered. Today the codes can only be used by those who have purchased the copyright license to the code book. As a result, it is impossible to determine what was billed for, insure accuracy in billing, or negotiate for a better price. Insurance companies pay more, consumers cannot assist in reducing cost. The code monopoly needs to end.
Allow purchasing insurance for all coverage with an exclusion for an existing condition. A phase in of coverage for a controlled existing condition could be an option.
The best outcome for the existing bill is that it will self-destruct in conference committee. The likely outcome is that it will get even more expensive.